Tuesday 25 March 2014

Anger

I have been incredibly angry a lot lately. It's really hard work. I feel sorry for poor Adam having to live with me... well one moment I feel sorry for him and the next I feel so angry with him and wish he'd go away or at least be a bit more useful, interested or understanding. He's a good guy and many others would have given up on me by now. So I swing between really angry at him and breaking my heart at how awful it is for him to have ended up with someone as messed up and horrible as me.

The anger is not only at Adam, in fact it's more so with everyone else in the world. I just can't help seeing the worst in everything. In one way I know I am being overly negative, but in the moment I am incredulous that others wouldn't be as incensed as I am by the situation or person. I am having to completely avoid human interactions because I could ignite at any moment. Family are particularly annoying and I feel I must hibernate to recover for several days after each encounter... and Facebook. Everyday I look over my Facebook news feed to see what my friends have been posting because that's what I used to do out of interest, but now I find myself having to bite my tongue (or thumb) because I can think of a disagreeable thing to respond to almost everything on there.

It's very hard work feeling so enraged constantly. It flares up sometimes for no reason at all. I'll just be sitting on my sofa minding my own business and then I'll remember something that I already got annoyed about days ago, eg an interaction, and then I'll be angry all over again. And I find it almost impossible to not want to verbalise it then. Adam is sick of hearing me complaining and he rarely agrees with anything. I think he notices negatives even less than the average person. In fact, mostly he's just completely oblivious to people being rude or unfriendly to him, whereas I always pick up on any hints of an attitude and feel a need to talk about it with Adam afterwards. It would just be nice if sometimes he'd go: "Yeah, I know what you mean, she was rude!" and then I'd feel better and could forget about it. But we're polar opposites in this area and I just don't seem to be able to learn to keep my mouth shut. It's like I always expect telling him well help and it never does. The other thing is, if I didn't speak my woes, I'd have nothing at all to say because it's mainly all woes.

It's not only people that infuriate me; my patience is non existent. If I'm trying to do something and it's not going straight forwardly I am enraged. Even my cat has been annoying me and he's just an adorable fluff ball really. But I think he senses my anger and doesn't cuddle me as much and then I'm angry with him for not cuddling me. I don't like being this way. I hate myself as much as I hate the world at the moment, if not more. I am a horrible, horrible person and no one would want to be around me like this (and yet I get angry at Adam for not seeming 'into' me). I am being just so destructive. I'm being like two of my siblings who I've never been able to understand: they are mean and angry and see the worst in things and act like the world has done them a disservice and I never understood why they couldn't just see the best in things and get along with people. Yet suddenly, it's like a monster has invaded me and taken over my being and all I want to do is scream and break stuff and throw things and tell every person all the things they've done to annoy me, of which there are many. I've punched mirrors, banged my head off doors, thrown my phone at the wall, smashed stuff. It just doesn't help.

I'm trying to see the positives in things. I don't want to be this way. It's so exhausting. I believed we make a choice about how we look at things but it feels like I have no control. The only thing I feel I can do is try to keep away from people so that I don't destroy my relationships. Unfortunately I can't get away from Adam.
I've said to him it would be better if I go away and he doesn't respond. I know it would be better for him. I wish I could go away and get better and come back and appreciate my life and my husband. If things go on this way, my relationship might not be able to recover.

Apart from angry, I'm also feeling a lot of sadness and despair lately too. Everything makes me cry. I mean EVERYTHING. I can't watch the TV for more than five minutes without having to blink back tears. Most times it's something ridiculous like a soppy moment in a comedy. Or someone won the 'Win the adverts' in Ant and Dec's Saturday Night Takeaway last week and I almost burst into tears. What the heck. I've also had more full on bawling my eyes out in despair sessions in the last month than I probably had in the previous five years.

I don't know about all of this. In a way, much of my trouble is that I don't usually feel. It usually gets displaced into physical symptoms or I dissociate, so does that mean this is a good thing? Because it doesn't feel like it. And my physical symptoms are nearly as bad recently as they were before I ever started going to therapy (that was one thing that had drastically improved for me). I'm getting sickness, pains, headaches more frequently. I feel like I am in mourning for something. I feel like I'm mourning my entire life: my father, my mother, myself, what I believed I had from T; the loss of hope. I always had hope. I always believed I'd get better, that T could help me. Well, she said she could, so I believed her. I don't anymore. I have little belief that things can be truly better. I might not always feel as bad as I do now but I feel hopeless about ever really being able to live. I'm feeling sorry for myself in the worst possible way, but it just feels like I'm finally being real and seeing things as they really are.

 I feel like I am out of control. I'm in a very dark place. I'm sabotaging every good thing in my life. My self esteem couldn't be lower. If Adam were to challenge me, I would crumple into a bawling heap of despair and self loathing. And I still don't know what, if anything, is going to help me get through this. At the moment, I am seriously considering looking into asking if I can get NHS funding to go to a residential unit that helps people affected by trauma. I contacted the hospital in the past and they said they felt I would be a good candidate, but at the time I couldn't imagine the prospect of leaving Adam for up to a year, especially with it being across the water and what would I tell my family. Now I feel it might be the best thing for both of us before I completely destroy my life. And if an intensive treatment could help me get better and start living it would be worth the time investment, because let's face it: I'm no better now than I was five months ago. I could be in this bad place for another five months yet and I could have gone and come back in that time.

Thursday 13 March 2014

Gaps in the Service (NHS)

In the last depressing post, I told you about how things went pear shaped last year. So what happened after it all went wrong? November was pretty awful. December was really bad but less 'risky' and January to March have just been dark; not risky, but dark.

In November (I think), there was one miserable day that started with dissociated cutting (it happened out of the blue while I was loading the dishwasher); then a child part calling T on the phone to tell her that she was scared which then resulted in me going down to see her at her office and her having to try to make arrangements for my safety. Because T was concerned about the risk of me ending my life she tried to refer me to the 'Home Treatment Team'. I was having suicidal thoughts and couldn't promise her I would be safe, you see. The Home Treatment Team assess people to see if they need to go into hospital or if they can be supported to stay at home with daily visits etc. I agreed to the referral, partly because I knew I didn't have a choice and partly because I was also scared for myself and felt if I could just be locked in a room I couldn't do too much until this passed. She rang them to refer and they basically told her they wouldn't accept the referral because I didn't have 'a serious mental illness'.

In these parts there is this thing about mental illness being different from conditions like personality disorders. The Home Treatment Team don't accept people with personality disorders because they don't see that as mental illness. I'm not really sure of the details of this so correct me if I'm wrong, but it might be something to do with absence of psychosis that they reject you for.  I don't have a personality disorder, to my knowledge (and I have checked with T a few timesabout this). I have a dissociative disorder. Because this is seen as something that is caused by experiences, it's not seen as an illness ie it's an adaptive coping mechanism or a neurosis. I agree, my problems aren't going to be all sorted out by medication; my problems are more likely to be sorted out by someone helping me to work through the trauma. BUT, if I am suicidal I am still in need of protection and probably medication to see me through that time and prevent me from ending my life. Also, who's to say that the two are mutually exclusive? It may be that I have Dissociative Identity Disorder but also have a depressive episode that is serious. And surely if one of my alters is trying to end my life, my thoughts are in some way disordered at that time? It just seems like a bunch of words and definititions that have been made up, probably for a good reason, but a side effect is an issue where real people who need help don't get it.

The problem is, if someone who doesn't have a serious mental illness diagnosis is suicidal then what is to be done for them; because to my knowledge, hospital admissions have to go through the Home Treatment Team? (I would personally question how someone can be suicidal and not mentally ill: again, it's all just words isn't it?) What are these people to do? Well, T was advised to refer me to psychiatry and the Self Harm Team. These would have been wonderful ideas, perhaps for me on any day over the previous few months where I was going downhill but in my crisis at that moment, waiting three months for an appointment with a psychiatrist wasn't really very helpful. Or as T put it: "there is a gap in the service".

So because I fell under the category of not mentally ill, in the Home Treatment Team's opionion I was refused the only route of access to safety and protection the local Health Trust had to offer. It seems like, if you don't have this magical diagnosis then you can f**k off and die somewhere else. Having a diagnosis of DID is just a slap in the face from all angles. My doctor won't acknowledge it: ask my GP what my record says and she will say I have chronic depression, not DID, not even a dissociative disorder, because her computer doesn't have a code for that. And so she will not talk of, or acknowledge anything but depression with me. Yet ask the Home Treatment Team to help and they won't acknowledge me because I have a dissociative disorder. More words and definitions that forget about human lives. What about individual human beings who are real people? If the people in that team were dealing with a member of their own family who was suicidal, would they be refusing them an assessment? I very much doubt it. They'd be doing everything they possibly could to make sure that person was safe.

If my understanding of any of this is wrong, I DO NOT apologise. Because, I am not stupid. If I can't understand how the services work then there is something wrong with how the services are communicating with service users. All I know is, I needed help and it was refused. I wonder how many people have been in the same situation as I was in and did not live to complain about it in a blog post? Who speaks up for those people? A gap in a service where it involves people who are in danger of death is not going to be highlighted by those who die by suicide. They can't speak up and tell the world that they were refused help.

For me, at that moment, on that day, I wasn't surprised. I knew enough of how that team works. In fact, if I'd been more my usual self I would have thought to tell T not to bother calling them as I would have known how it would go. I was actually relieved not to be taken on for assessment because the last thing I wanted was interference that wasn't simply just locking me up so I couldn't hurt myself if I switched to the part that wanted to die. I would have accepted going into hospital for my safety but I did not need someone coming round my house daily to check I was still alive. My issue at that moment was not that I was planning to end my life, but that another dissociated part was planning to do it and I was afraid I could not control that part. I felt I just needed a place of safety.

So what happened? Adam came to T's office where I was waiting, wishing the ground would swallow me up. I love my T and sympathise that she also could not find support that I needed and probably felt a bit alone at that time too but I could see how the process needed to go. She had a professional responsibility to ensure I had a safety plan; I'd already said I couldn't promise I wasn't going to end my life so she had to act on this. She was denied help as much as I was. So what was she to do? She needed to have it recorded that I had a safety plan; I suppose that's something they have to do. In the end I just had to lie. I had to say I wasn't going to hurt myself, even though I didn't know if I would or not. I'm sure she understood that it wasn't in my gift to make that guarantee but she needed it documented that I had a safety plan. I still feel bad about the fact that I just had to help her tick that box by being dishonest. She'd only recently told me that she admired my honesty (as a quality that I have in general) and there I was clearly just agreeing to something I didn't honestly believe I could stick to if I dissociated into the other part.

We also agreed Adam would look after my medication because I admitted I had been Googling how to take an effective overdose. I felt angry about this; like a child being punished. You know... "If you can't act responsibly 'insert something you own here' will be confiscated until you can". I know my feeling angry is my own issue and that they were just trying to help me. I know it's to do with feeling like people were trying to control me and take away my choices. I'd already discovered from my research that an overdose really isn't the most reliable way to go about ending your life and I knew that if I wanted to hang myself I could always find the means, but the latter was agreed by T, that we couldn't eliminate everything but we wanted to minimise risks. I did not agree to giving Adam my blades and I think T could see that it would make things worse to do so. They are a safety net for me. I'm a bit like Maggie Gyllenhaal in 'The Secretary' when it comes to my precious blade set. Getting rid of them completely has never been possible.

I felt SO ashamed that Adam was there having to be a part of my mess. So, so, so ashamed. I felt defensive inside and exposed and I felt like I was being punished for self harming just as I did when I was a child (more of my own issues when others are trying to help). I just wanted to die. I just sat there, between T and Adam, being asked to make promises I couldn't know I could keep and wishing I could just disappear and not exist anymore.

Well, I'm writing this post so clearly I was not at risk and the Home Treatment Team were right about me anyway weren't they? Or am I just one of the fortunate ones who managed to stay alive despite them? I would like to know if someone is keeping a record of the number of times people seek out help when they feel they are in danger and are refused and what happens to those people. Not one person should end their life after calling out for help or having someone seek help for them and it being refused. If that has ever happened (and I know it has), it is too many times to have happened.

What did I learn from this situation? Unfortunately, it further confirmed to me that if I am in a desperate situation, I can't expect help from my health service. I believe T did everything she could have done for me. She always treats me with respect. I think I have been lucky to be treated by her and I go about expecting the same of everyone else I encounter in the health service and am then constantly horrified when I am treated like an inferior being or a time waster. T always takes me seriously. I can see that she treats everyone as equal, including herself. Not everyone has the same life experience and this affects people in different ways but that doesn't mean they are better or worse. Also her understanding of my predicament in relation to it not being 'me' but another dissociated part was clear. I take that for granted actually. She 'gets it' so well that I forget how weird it probably sounds to other people because it's so normal for me and talking about parts with her feels as normal as talking about anything else. It's not something many people in everyday life would understand when they think of suicide: the idea of dissociation coming into play. They think of someone in a desperate place, full stop. They don't think of someone who feels like they are posessed by another entity who could take over and kill them at any moment, even though they themselves don't wish to end their life in that way. And believe me, I don't wish to.

I have considered suicide in the past; long and hard. That is my nature: I think things through. And I am logical. Although I struggle with feeling like I don't want to be alive at times, I also have the capacity to see that suicide would devastate people who love me and have very negative effects on other people who know me. I also have the capacity to realise that if I can tolerate being alive, there is always a chance that things will get better. And life is tolerable for the most part. Sometimes it feels awful and I feel hopeless and wish I didn't exist but I don't want to hurt other people and if I keep breathing in and out and time goes by, maybe things will change. And sometimes I do laugh or feel the sun's warmth on my neck or listen to a bird chattering in a tree and in those moments, I am alive.

Wednesday 5 March 2014

Where it all went wrong

Last year things started going downhill for me. I'd had a good year on Venlafaxine since my previous 'crash' at the start of 2012 that was triggered by the departure of my clinical psychologist, T who went away for six months. After she returned and I had returned to work on a high dose of the aforementioned Venlafaxine, things were OK from summer 2012 to early 2013. Things are never brilliant for me: I still have dissociative identity disorder and I still struggle on a daily basis with all of the issues it causes, but I could function reasonably well and I felt 'OK'.

But to get back to what I started off by saying... yes, things went downhill last year, or as one psychiatrist once put it: "tits up". This time it sort of went 'tits up' quite gradually at first but at around October last year, made a rather dramatic belly flop which saw me going off on sick leave from work and losing the ability or will to do much at all. October was over four months ago and I am still off work but I have now been off longer than the entire duration of my sick leave of the 2012 'crash' and I don't feel anywhere near being able to go back to work. I can't imagine managing it.

"So what went wrong last year?" I hear you ask (the question every health professional I've seen since October wants the answer to). I don't know. I hypothesise that it was not any one thing on its own but a number of things that combined to mean I was struggling a lot and then there was a final straw on my back that just sent me over the edge.

First, I think having DID maybe just makes me fragile. Don't take that the wrong way, I don't mean that if you have DID it's because you're weak or anything... I just mean... if you're managing having a dissociative disorder, you're already managing A LOT. It can be hard just coping with daily life when you find yourself variable, triggered without notice, losing yourself, losing the world, absorbed then detached, exhausted... whatever way you find yourself. It's hard. Dissociation is only useful when it's useful. In other words, it was once useful for me to blank things out and forget or not feel when bad stuff happened but nowadays it causes more trouble than it's worth but it still happens. So when everything is hunky dory, it can still be tricky managing 'normal' life and it doesn't take an awful lot to make managing impossible.

The happenings of last year in a nutshell were because of family stuff. I don't want to delve into this too much but to summarise: someone who hurt me a lot and who I still have trouble thinking about moved to live near me, having been far away for a long time. OK it was my father: it's no big secret that he hurt me. He's a very volatile person and I'm pretty sure is completely narcissistic (if not a psychopath). I have managed my feelings about him by not having much to do with him recently. The knowledge that he was moving to live near me sent me into a tailspin and I noticed a clear decline in my functioning from the very week I heard about it.

This has been a huge thing actually. I didn't see him after he moved and after being ambivalent about if I even wanted to see him, he cut me off from the little contact we did have. You know how it is... it was a relief in a way but it still hurt. I don't want my dad in my life because he still hurts me, yet I love him and there's nothing I want more than to be loved by him. I guess last year involved a further realisation (because I'm so thick the previous years' of my life hadn't proved it enough) that he doesn't love me and being rejected by him was hard even though it was a relief not to have to worry about seeing him. I still do worry though. He knows where I live and I know what he's like. I wouldn't be surprised if he turns up on my doorstep one day.

What happens when narcissistic people have kids? I am no psychologist but I guess they end up producing people like me, who believe they are worthless and feel like they will never be good enough to be loved. They also seem to be able to produce people like themselves too and that is where two of my siblings come in, who have inherited or learnt to be completely self absorbed, combined with completely lacking in self worth but at the same time feeling like the whole world owes them something and feeling the need to constantly criticise and put others down. Nothing and no one is ever good enough for these two and the problems in their lives (of which there are many) are everyone Else's fault, including mine apparently. One of my siblings fell out with me last year because I stood up for myself for the first time after always ignoring their outbursts. We haven't really spoken since as they refuse to talk about what happened.

The other one, just never contacts me unless I contact her and I miss her, yet having seen her once last year and once this year so far, I'm afraid I may be better off missing her rather than spending time with someone so self obsessed and uninterested and then feeling bad about that. I saw her recently for the first time in a year. I've tried to arrange meet ups before but she just wouldn't bother replying. I finally managed to get her to come to my house and I made loads of effort to make it really nice for her. I asked her all about her work and made conversation about her interests when we were chatting, as you do when you're interested in someone. She didn't ask me one single question! She just went on and on about herself and how fabulous she is. And there I was worrying about what I'd say if she asked me how work was going; turns out I needn't have worried. Not that I'm really surprised. I shouldn't be at all surprised by now.

I think it's easy for people around me to look at my family dramas and think 'that's nothing new' because my family has had its dramas for many years (honestly, we could have our own show). It may not be obvious to people though that the past year might have affected me more than others because I am not usually involved in the dramas to the extent of last year. I mean, people got annoyed with me for no reason in the past and fell out with each other and all that but I never made a stand until the past year or so. I always let people just get on with it. I am proud of myself for standing up for myself to some degree but I am sad because I feel I have lost my father for good and two of my siblings.

My remaining grandparents died within the past year or so too, in unpleasant circumstances and although I wasn't close with them, it was another strain and also highlighted to me what I hadnt had with them.

Ugh, this post is full of self pity and I didn't mean it to be like that. It's also way too long. I wanted to write a summary of what happened, not a book. I apologise for how long this is. No, wait! I take it back. 

The other thing that has been hard was work. I'm definitely not going to blab on about this. It's just been really hard to manage even while taking annual leave a day a week to help me attend clinical psychology sessions and recover. My functioning was not so good after the family stuff and what little EMDR we did manage affected it further and then I started getting negative feedback and negative 'vibes' from my team and my confidence in my ability got a real knock... I don't think it recovered. I don't know if it is me or not that is the problem. In a way I think the demands placed on me were unrealistic but then I wonder if I'm just protecting my ego by thinking that. In reality it was probably both unrealistic demands and my decline in functioning that was making work become a real nightmare. I was really struggling to manage working as my mental health was not good but it wasn't doing me any favours as I was just getting told I wasn't good enough. I should have gone on sick leave as soon as I felt unwell really instead of trying to keep going and not managing well. The demands aren't likely to get any easier if I do go back and if I'm honest, makes me scared of getting well enough to go back. If I get back to my DID baseline, I still won't be able to manage.

The final straw on the Candy's back last year came when I basically sabotaged my relationship with T, my clinical psychologist, just as we were getting started on the EMDR. I had noticed that she was acting differently towards me for a month or two (she seemed cold and unresponsive) and I think this triggered off my internal debates about my relationship with her and her feelings about me. There was so much going on in my head, a lot to do with thinking she hates me and parts wanting to know if she really would be there for me if we needed her and I guess I thought the best way to handle that was to try to find out from her what she actually did feel and to see how 'there for us' she could be... that backfired (or worked perfectly depending on who's looking at it) when she told me, and I quote, that she "neither likes nor dislikes" me. SLAP IN THE FACE! I know I'd worried that she didn't like me so I should have been reassured but I think some part of me felt like she did like me; I thought I had sensed an affection from her.

I also asked if she minded me emailing as I had used this as a way of managing when I was having a particularly bad time between sessions. I'd done it for a while and she generally would have just given me a short reply but I'd never really discussed with her if she minded and I guess I got to a point where I wanted to know if she did because I didn't want to do it if she didn't feel happy with me doing it. She said she didn't mind but that she couldn't guarantee she'd read it immediately. I was fine with that but then she decided to make some kind of 'boundary' and say that she wasn't going to read anything I sent her until just before my session with her and that she wasn't going to send responses. I felt bad about this as the point of me sending them really was to feel like I had shared my pain with her and she could hold it until I met with her. I didn't really mind her not replying as she never had said much anyway, only to acknowledge the email but knowing that it wouldn't be read meant I hadn't really shared my pain with her, it would just be sitting in her email folder waiting until the session, so what's the point as I wouldn't feel like I'd told her and she'd hold it (this may not make sense as I haven't explained it well, but it does in my mind). She also let slip that she didn't like me emailing her, even though she said she didn't mind, but it came out without her meaning to say it or I think, noticing that she'd said it, later in one of our painful discussions where we were trying to understand each other and why it was such a big deal for me. She also said something, another slip, about not being a match or something. I can't remember the words but at the time it seemed like she felt we weren't 'working'.

It is hard to be told by someone who to you has become the nearest thing to a healthy parent relationship you've had, that they don't like you and to find out that your emails, which have been a real coping mechanism for you, are actually bothersome to them. Especially when some of your biggest issues are to do with feeling like you are unlovable and you grew up knowing that you came into the world 'a mistake'.
I just can't get my head around it. It may seem like a small setback, but those conversations with T shattered me. That was not the straw that broke the camels back really, it was the avalanche that completely engulfed me and the truth is I'm still lost in the snow, although I think now, four months later, it's like I've managed to craft myself some sort of igloo underneath it and I'm surviving by passing each day not thinking of how to get out, because escape seems unlikely, but just waiting for the days to pass to bring me closer to whatever way I will die. I think I've lost the will to even make it out. I'm painfully content in this dark place where I don't have to be living anymore, even though I'm not technically dead.


This old draft proves the point I failed to make...

I found this draft of a post I started to write called: 'Flitting'. I just found it humorous that I was trying to write a post about my inability to complete a task and then I failed to complete the task...

"I can't complete a task at the moment. There is so much I want to do with my weekend. I mean, just little things in the house but each time I try to do one thing I get overwhelmed by the complexities of the task. Or I just don't get to trying one thing because there are just so many things that I don't know where to start. To illustrate the former; I tried to go online to buy a replacement part for the shower... who knew there were so many options when it comes to showers?..."